Comparison of Vascular Calcification Scores on Plain Radiographs as Predictors of Coronary Artery Disease in Hemodialysis Patients

Kim, Jung Min; An, Won Suk; Kim, Ki Hyun; Kim, Seong Eun; Son, Young Ki; Chung, Seuk Hee; Oh, You Jeong; Kim, Woo Jai; Kim, Dong Kyun; Bae, Hyang Suk

Abstract

PURPOSE
Vascular calcification (VC) scores on simple plain radiographic films are known to be associated with coronary artery disease (CAD) and mortality. The present study was designed to demonstrate a correlation between VC scores of the hands and pelvis, and feet and lateral lumbar spine on plain radiographs. In addition, we analyzed the usefulness of checking all the plain radiographs for assessment of pre-existing CAD.
METHODS
We recruited 61 hemodialysis (HD) patients from OO Dialysis Center. We checked the plain radiographic films of the feet, hands, pelvis, and lateral lumbar spine and evaluated VC scores with previously reported methods. We defined CAD based on myocardial scans, echocardiography, or coronary angiography.
RESULTS
Positive associations were found between the VC scores of the feet, VC scores of the hands and pelvis, scores of abdominal aortic calcifications (AACs), and CAD. Approximately 30% of patients who had CAD could be missed based on a single VC scoring method. Patients who showed any one finding among the AAC scores >5, VC scores of the pelvis and hands >3 or arterial media calcifications of the feet on plain radiographs had a high sensitivity (93.8%) and a high negative predictive value (96.3%) for the presence of CAD.
CONCLUSION
Each VC score was highly inter-correlated. All three VC scoring methods on plain radiographic films are useful screening tests for the presence of CAD in HD patients.